Trastuzumab biosimilar in early breast cancer setting: will there be direct patient benefits?

The inclusion of trastuzumab in the management of both early and metastatic HER2-positive breast cancer has significantly improved survival of these patients and is regarded as a standard of care. However, the cost of 12 months of adjuvant trastuzumab which is currently regarded as the standard duration of administration and an indefinite use of trastuzumab in the metastatic setting, limits the global use of this monoclonal antibody for all patients. The latter was shown in our Lancet Oncology Commission of cancer control in China, India and Russia; where these three nations account for 40% of the world’s population. At the time of our report in April 2014, approximately one third of breast cancer patients in China with HER2-positive disease were able to access trastuzumab (1).